Drug scarcity frustrates ADHD patients

Article by: JEREMY OLSON

Star Tribune

April 26, 2011 - 8:39 PM

A shortage of stimulants to treat ADHD -- attention deficit hyperactivity disorder -- has forced some Minnesota patients to pay more for expensive brand-name medications or make a frustrating switch to short-acting versions of their drugs, according to local physicians.

While generic versions of Ritalin, Methlyn, Concerta and Metadate are in short supply, according to the U.S. Food and Drug Administration, it's the lack of the generic version of Adderall XL that is causing the most headaches, said Dr. Carrie Borchardt, a child psychiatrist for Children's Hospitals and Clinics of Minnesota.

That is the only generic stimulant available in an extended-release form, which means patients with ADHD only need to take one pill a day to gain control over their inattention, agitation or other symptoms.

While patients could obtain brand name drugs in extended-release forms, many insurers won't pay for them.

So Borchardt said some of her patients are, instead, taking short-acting ADHD medications and swallowing multiple pills a day. That is a particular problem for school children, she said, because the short-acting drugs might wear off before they take their next doses. It can also disrupt their school day for a trip to the nurse's office and alert classmates to the students who have ADHD, Borchardt said. "Then their classmates all know. School is hard enough for (these students) the way it is."

Dr. L. Read Sulik, a child psychiatrist with Sanford Health, agreed the switch to shorter-acting medications has been the biggest problem of the drug shortage. There have been scattered reports, though, of patients missing doses or calling multiple pharmacies to secure their usual medications.

The shortage is expected to be resolved in the next month or so, according to the FDA's drug shortage website.

Reasons for the shortage are unclear. The same company, Shire Pharmaceuticals, makes both the generic version of Adderall XL that is in short supply and the brand name version that remains broadly available. However, the marketing and distribution of the generic form is handled by Teva Pharmaceuticals.

Reasons listed on the FDA website include increased demand for generic stimulants and federal quotas that prevent too much of certain controlled substances from reaching the market at any given time.